| Abstract [eng] |
The aim of this study is to compare disk diffusion and automated methods for determining the Enterobacteriaceae extended spectrum-β-lactamases (ESBL) phenotype and to assess the prevalence of (ESBL) at University Hospital Clinics in 2008-2010. For the study were chosen 58 bacteria from the Enterobacteriaceae family that were isolated in 2009-2011 in patients that were treated at Vilnius University Hospital Clinic. The bacteria studied using phenotypic methods ESBL: Phoenix automated system (Becton Dickenson, Sparks, MD, USA) combined disc diffusion method and the double-diffusion method. Automated system of Phoenix for the study was considered as a method of confirming the identification of bacteria and determination of (ESBL) production phenotype. The studied group consisted of the following bacterial species: K. pneumoniae, E. coli, Enterobacter spp., Proteus spp., Serratia spp., Morganella spp. and Providencia spp . The examination with the validated method of 58 bacteria showed that 31 of them produce an extended spectrum beta lactamases. A performed comparative disc diffusion method was made and the evaluation of the sensitivity, specificity, positive prognostic value (PPV) and negative prognostic value (NPV) was identified. The evaluation of the data from studies showed that the combined disc diffusion method for sensitivity - 100% and specificity - 100%, PPV - 100%, NPV - 100%. Double-diffusion method for sensitivity - 100% and specificity - 88.9%, PPV - 91.2%, NPV - 100%. The obtained results show that disk diffusion methods are sensitive and reliable for determination of bacteria producing ESBL phenotype. The analysis of the Enterobacteriaceae producing ESBL prevalence in 2008-2010 in selected sections showed that within three years, there have been isolated in 2721 Enterobacteriaceae, of which 536 (19.7%) were strain produces of an extended spectrum beta lactamases . It was found that in 2008 848 Enterobacteriaceae isolated, of which 129 (15.2%) were producing ESBL, 2009 -965 Enterobacteriaceae from 225 (23.3%) producing ESBL in 2010 - 908, of whom 182 (20%) producing ESBL. ESBL are mostly produced by K. pneumoniae, 257 (47.9%), E. coli 132 (24.6%) and Enterobacter spp. 85 (15.9%). Maximum producing of ESBL bacteria was in the I reanimation the intensive care room. |
